Nurse Case Management

 We offer a greater integration between the utilization review and bill review processes. Our expert bill review staff will create the highest possible savings allowed by the fee schedule, while providing this service in a transparent, efficient way.

Our Return to Work program is a collaborative process between the provider and the employer to ensure job demands or light duty availability is effectively communicated for safe and early return to work. We can also work with the employer to create customized bridge programs to your departments and company that allow facilitation of safe early return to the workplace where it was not previously possible.  

In the event that an employee is unable to return to their job of injury as a result of a work accident, JMS is able to provide a Vocational Rehabilitation Evaluation for the employee to identify career options for returning to the workforce within the limitations that may or may not have been placed on the client as well as their vocational background and life skills. Vocational rehabilitation can even collaborate with the injured worker to develop their resume, write cover letters, and construct a job search plan.

JMS Pre-Auth services have the knowledge and tools to eliminate waste and unnecessary services, while avoiding harmful delays in care. We allow for great impact to assure medical necessity.

Catastrophic claims are something we all pray never happens but we must be prepared for. That’s why we have a team of registered nurses prepared and ready to jump into action to provide seamless communication and coordination of care for the patient needs as they transition through the rehabilitation process.

Using expert analysis, our Certified RN MSA Consultant estimates every possible future medical expense related to an injury, including prescriptions, tests, surgeries, other medical procedures, doctor’s visits, supplies, etc. We then file the final MSA proposal with CMS and assist in preparation of settlement documents for funding, and administration of the allocation funds. Our legal partnership will take care of structuring settlement allocations.

Pre-MSA Medical Cost Projections can be performed to determine areas where medical expenditures can be reasonably decreased and lower exposure

• Submissions and nonsubmissions

• PreMSA Reviews

• WCMSA and Liability MSA

One of the most effective tools in controlling work comp costs is prompt referral for Medical Case Management. For full Medical Case Management or Task Assignments, our RN Case Manager utilize the best providers assuring reasonable and necessary treatment.

Don’t be stuck with a physician that is either not well versed in workers’ compensation or is steering your claim off the appropriate treatment path. Have a lady in blue coordinate an independent medical evaluation for your claim with an unrelated provider to allow an expert third-party opinion in the treating field assess the patient, opine on the appropriate treatment plan, and get your file back on track!

Workstation Assessments are an ergonomic analysis of a work area to document the physical demands and identify risk factors for: appropriate job placement, musculoskeletal disorders (MSDs), inefficiencies in production, and areas needed for change or adaptation.

Our staff are focused on assisting employers, employees, and carriers with specialized needs in the workplace. Our Occupation Consultants can help you with injury prevention, injury causation determinations, light duty programs, Ergonomics Programs, and RTW Assistance.

Work comp claims close 70% faster with a RN Case Manager.(TCM) is designed to impact injury claims with early intervention, and without onsite travel expenses.

Nowhere else can an attorney find this level of cost effective expertise understanding the terminology and subtleties of the healthcare system. We bridge that gap in the legal team – let our JMS Ladies in Blue work with your legal team for the best outcomes!